A new modified inside-out repair technique of arthroscopic meniscal repair for peripherally torn menisci is described. Under arthroscopic control, after conventional inside-out technique using meniscal repair set using outside-in technique with 18-gauge needle, horizontal mattress sutures of absorbable monofilament(PDS 2-0) were placed across the tom site and tied over the capsule or fascia. Nearly all portions of meniscus were possible with this technique except most posterior and anterior portions. As this is the modification of inside-out technique, neurovascular complications could be avioded. The problem of outside-in technique, knot irritation inside joint could be avoided also because the knot is outside of the joint.
Fascia ; Joints ; Needles ; Sutures

Purpose: Lecture-based teaching is widely used in preclinical medical education, offering a systematic way to deliver complex information efficiently. However, its effectiveness heavily relies on the instructional behaviors of lecturers. Despite its importance, limited research has explored the specific differences between effective and ineffective teaching behaviors perceived by students. This study aims to analyze these behaviors systematically to provide actionable insights for enhancing teaching competencies. Methods: This study surveyed 92 first-year medical students to evaluate effective and ineffective teaching behaviors. A 30-item questionnaire was developed based on existing literature. Data analysis included descriptive statistics to rank teaching behaviors and chi-square tests to examine their correlations. Results: Effective behaviors included appropriate voice volume, clear pronunciation, error-free lecture materials, clear explanations of learning objectives, and humor. Ineffective behaviors were poor voice clarity, insufficient summarization, lack of follow-up session introductions, absence of online resources, and poor interaction. Significant relationships between effective and ineffective behaviors were observed in some items. Conclusion The study highlights those effective behaviors, such as recalling prior learning, utilizing materials, and engaging students, enhance learning outcomes. Faculty development should focus on avoiding ineffective behaviors for novice faculty and reinforcing effective ones for mid-career faculty to improve teaching quality in medical education.

Purpose: Lecture-based teaching is widely used in preclinical medical education, offering a systematic way to deliver complex information efficiently. However, its effectiveness heavily relies on the instructional behaviors of lecturers. Despite its importance, limited research has explored the specific differences between effective and ineffective teaching behaviors perceived by students. This study aims to analyze these behaviors systematically to provide actionable insights for enhancing teaching competencies. Methods: This study surveyed 92 first-year medical students to evaluate effective and ineffective teaching behaviors. A 30-item questionnaire was developed based on existing literature. Data analysis included descriptive statistics to rank teaching behaviors and chi-square tests to examine their correlations. Results: Effective behaviors included appropriate voice volume, clear pronunciation, error-free lecture materials, clear explanations of learning objectives, and humor. Ineffective behaviors were poor voice clarity, insufficient summarization, lack of follow-up session introductions, absence of online resources, and poor interaction. Significant relationships between effective and ineffective behaviors were observed in some items. Conclusion The study highlights those effective behaviors, such as recalling prior learning, utilizing materials, and engaging students, enhance learning outcomes. Faculty development should focus on avoiding ineffective behaviors for novice faculty and reinforcing effective ones for mid-career faculty to improve teaching quality in medical education.

Purpose: Lecture-based teaching is widely used in preclinical medical education, offering a systematic way to deliver complex information efficiently. However, its effectiveness heavily relies on the instructional behaviors of lecturers. Despite its importance, limited research has explored the specific differences between effective and ineffective teaching behaviors perceived by students. This study aims to analyze these behaviors systematically to provide actionable insights for enhancing teaching competencies. Methods: This study surveyed 92 first-year medical students to evaluate effective and ineffective teaching behaviors. A 30-item questionnaire was developed based on existing literature. Data analysis included descriptive statistics to rank teaching behaviors and chi-square tests to examine their correlations. Results: Effective behaviors included appropriate voice volume, clear pronunciation, error-free lecture materials, clear explanations of learning objectives, and humor. Ineffective behaviors were poor voice clarity, insufficient summarization, lack of follow-up session introductions, absence of online resources, and poor interaction. Significant relationships between effective and ineffective behaviors were observed in some items. Conclusion The study highlights those effective behaviors, such as recalling prior learning, utilizing materials, and engaging students, enhance learning outcomes. Faculty development should focus on avoiding ineffective behaviors for novice faculty and reinforcing effective ones for mid-career faculty to improve teaching quality in medical education.

Purpose: Lecture-based teaching is widely used in preclinical medical education, offering a systematic way to deliver complex information efficiently. However, its effectiveness heavily relies on the instructional behaviors of lecturers. Despite its importance, limited research has explored the specific differences between effective and ineffective teaching behaviors perceived by students. This study aims to analyze these behaviors systematically to provide actionable insights for enhancing teaching competencies. Methods: This study surveyed 92 first-year medical students to evaluate effective and ineffective teaching behaviors. A 30-item questionnaire was developed based on existing literature. Data analysis included descriptive statistics to rank teaching behaviors and chi-square tests to examine their correlations. Results: Effective behaviors included appropriate voice volume, clear pronunciation, error-free lecture materials, clear explanations of learning objectives, and humor. Ineffective behaviors were poor voice clarity, insufficient summarization, lack of follow-up session introductions, absence of online resources, and poor interaction. Significant relationships between effective and ineffective behaviors were observed in some items. Conclusion The study highlights those effective behaviors, such as recalling prior learning, utilizing materials, and engaging students, enhance learning outcomes. Faculty development should focus on avoiding ineffective behaviors for novice faculty and reinforcing effective ones for mid-career faculty to improve teaching quality in medical education.

Arthroscopic treatment has been reported to provide effective improvement of ankle function when used in treatment of small osteochondral lesion of talus; however, favorable long-term results have been less predictable for large osteochondral lesion of talus. In cases in which primary arthroscopic treatment fails, the decision regarding which subsequent technique to choose has become increasingly difficult, as good clinical outcomes may be unlikely for such patients irrespective of the surgical technique used. Redomicrofracture should be used judiciously for treatment of osteochondral lesion of talus in which arthroscopic treatment has failed.
Ankle ; Humans ; Talus*

Lateral spinal artery (LSA) aneurysms are extremely rare lesions that can rupture and cause subarachnoid hemorrhage (SAH) even though the spinal arteries communicate directly with the subarachnoid space. To date, six cases of LSA aneurysms have been reported in the literature. Herein, three such cases are reported. All patients presented to the emergency department with headaches. The patients in the first two cases were confirmed to have SAH and LSA aneurysms on a brain computed tomography (CT) angiography performed at the hospital. Two patients had prior instances of cerebral infarction and coronary disease, respectively, and were undergoing antiplatelet therapy. The antiplatelet medication was stopped for 2 weeks and 1 week, respectively, while conservative care was provided. Subsequently, a suboccipital craniectomy was performed, followed by aneurysm clipping. Following the surgery, both patients were discharged without any significant neurological deficits. Regarding the third patient, no aneurysm was found on brain CT angiography, and cerebral angiography was performed during the patient’s hospital stay. She was hospitalized, where she received medication and conservative care, and was discharged with an improvement in bleeding without neurological symptoms. Subsequently, a LSA aneurysm was identified on a brain CT angiography performed at an outpatient clinic; however, the patient was transferred because she wanted to be treated at another hospital. LSA aneurysms are difficult to visualize using CT angiography; therefore, careful angiographic studies are required. Surgical clipping is the treatment of choice if the aneurysm is inaccessible by the endovascular treatment.

Transplantation studies about the clinical differences according to the type of donors are mostly conducted in western countries with rare reports from Asians. The aims of this study were to evaluate the clinical impacts of the type of donor, and the predictors of 1-year mortality in patients who underwent liver transplantation (LT). This study was performed for liver transplant recipients between May 2010 and December 2014 at the Pusan National University Yangsan Hospital. A total of 185 recipients who underwent LT were analyzed. Of the 185 recipients, 109 (58.9%) belonged to the living donor liver transplantation (LDLT) group. The median age was 52.4 years. LDLT recipients had lower model for end-stage liver disease (MELD) score compared with better liver function than deceased donor liver transplantation (DDLT) recipients (mean ± standard deviation [SD], 12.5 ± 8.3 vs. 24.9 ± 11.7, respectively; P < 0.001), and had more advanced hepatocellular carcinoma (HCC) (62.4% vs. 21.1%, respectively; P = 0.001). In complications and clinical outcomes, LDLT recipients showed shorter stay in intensive care unit (ICU) (mean ± SD, 10.8 ± 8.8 vs. 23.0 ± 13.8 days, respectively, P < 0.001), ventilator care days, and post-operative admission days, and lower 1-year mortality (11% vs. 27.6%, respectively, P = 0.004). Bleeding and infectious complications were less in LDLT recipients. Recipients with DDLT (P = 0.004) showed higher mortality in univariate analysis, and multi-logistic regression analysis found higher MELD score and higher pre-operative serum brain natriuretic peptide (BNP) were associated with 1-year mortality. This study may guide improved management before and after LT from donor selection to post-operation follow up.
Asian Continental Ancestry Group ; Busan ; Carcinoma, Hepatocellular ; Donor Selection ; Follow-Up Studies ; Gyeongsangnam-do ; Hemorrhage ; Humans ; Intensive Care Units ; Liver Diseases ; Liver Transplantation* ; Liver* ; Living Donors ; Mortality* ; Natriuretic Peptide, Brain ; Tissue Donors* ; Transplant Recipients ; Ventilators, Mechanical

BACKGROUND: Tumors with cysts often correlate with gliomas, metastatic tumors, or hemangioblastomas, which require differentiation. METHODS: Thirty-eight cases of cyst associated-meningioma based on preoperative radiologic studies and histologic confirmations were reviewed from November 1998 to July 2017. RESULTS: A total of 395 cases of meningioma were observed in the 20 years, and surgical treatment of intracranial meningioma was performed in 120 cases. Thirty-eight (9.6%) cases of cyst associated meningiomas were analyzed. Nauta type I was the most common type of cyst (39.5%) and the most frequent histopathological subtype was meningothelial type (36.8%). CONCLUSION: Statistically there were no significant associations between meningioma histopathological type and associated cysts; however, the rate of World Health Organization grade II was higher in cyst associated meningiomas than in unrelated meningiomas. This correlation was weak, in accordance with the meningioma grade.
Glioma ; Hemangioblastoma ; Meningioma* ; Neuropathology ; World Health Organization

BACKGROUND/AIMS: Infections following liver transplant (LT) remain a major cause of mortality. This study was conducted to evaluate risk factors for infection and to review clinical characteristics. METHODS: Medical records of patients who underwent LT from 2010 to 2014 were retrospectively analyzed. Binary logistic regression analysis was used to investigate risk factors of infection. Kaplan-Meier analysis was used to predict prognosis of infected and non-infected groups. RESULTS: Of 185 recipients, 89 patients experienced infectious complications. The median follow-up period was 911 days (range, 9 to 2,031). The infected group had higher 1-year mortality (n = 22 [24.7%] vs. n = 8, [8.3%], p = 0.002), and longer postoperative admission days (mean: 53.7 ± 35.8 days vs. 28.3 ± 13.0 days, p < 0.001), compared to the non-infected group. High preoperative Model for End-Stage Liver Disease (MELD) score (odds ratio [OR], 1.057; 95% confidence interval [CI], 1.010 to 1.105; p = 0.016), deceased-donor type (OR, 5.475; 95% CI, 2.442 to 12.279; p < 0.001), and acute rejection (OR, 3.042; 95% CI, 1.241 to 7.454; p = 0.015) were independent risk factors associated with infection. Intra-abdominal infection (n = 35, 20.8%) was the major infectious complication. Among identified bacteria, Enterococcus species (28.4%) were major pathogens, followed by Escherichia coli and Klebsiella species. CONCLUSIONS: High preoperative MELD score, deceased-donor type, and acute rejection were risk factors associated with infection. To prevent infections following surgery, it is important to determine the appropriate time of operation before the recipient has a high MELD score.
Bacteria ; Enterococcus ; Escherichia coli ; Follow-Up Studies ; Humans ; Intraabdominal Infections ; Kaplan-Meier Estimate ; Klebsiella ; Liver Diseases ; Liver Transplantation ; Liver* ; Logistic Models ; Medical Records ; Mortality ; Prognosis ; Retrospective Studies ; Risk Factors ; Transplant Recipients*